EP3989832B1 - Registrement des vaisseaux sanguins à l'aide d'informations fonctionnelles - Google Patents

Registrement des vaisseaux sanguins à l'aide d'informations fonctionnelles Download PDF

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EP3989832B1
EP3989832B1 EP20733452.5A EP20733452A EP3989832B1 EP 3989832 B1 EP3989832 B1 EP 3989832B1 EP 20733452 A EP20733452 A EP 20733452A EP 3989832 B1 EP3989832 B1 EP 3989832B1
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diagnostic image
vessel
interest
diagnostic
value
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EP3989832A1 (fr
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Christian Haase
Martijn Anne VAN LAVIEREN
Michael Grass
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Koninklijke Philips NV
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Koninklijke Philips NV
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Definitions

  • the present invention relates to a method for analyzing diagnostic image data, in some embodiments multi-modality diagnostic image data, a corresponding apparatus and a respective computer program.
  • the present invention relates to an improved method and apparatus that allows to more reliably and accurately perform correspondence detection for a vessel of interest in a patient's vasculature as represented in multiple diagnostic images by using functional parameter values.
  • CT Computed Tomography
  • IVUS Intravascular Ultrasound
  • MR Magnetic Resonance
  • ICE Intracardiac Echocardiography
  • TEE Transesophageal Echocardiography
  • fluid dynamics measurement modalities such as invasive Functional Flow Reserve (FFR) or Instantaneous Wave-Free Ratio (IFR) measurements, ultrasonic flow measurements, such as Doppler flow measurements or the like.
  • Each of the medical imaging modalities hereby allows to gather specific diagnostic image data revealing specific information about the vasculature.
  • This specific information may differ from imaging modality to imaging modality and even from diagnostic image to diagnostic image acquired using the same imaging modality, as acquisition settings such as projection direction, cardiac motion and the like may change the visualization of the vasculature in the different diagnostic images.
  • the so-called correspondence detection has to be performed during which the same vessel of interest - or segment thereof - is identified in all diagnostic images and, thus, is co-registered for all diagnostic images. That is, it is determined which vessel (segment) in a first diagnostic image corresponds to which vessel (segment) in a second diagnostic image.
  • an accurate correspondence detection is often prevented by factors such as changed projection direction, cardiac motion, the usually non-calibrated C-arm geometry or the like.
  • the same vessel (segment) may appear to have so different properties that a correspondence between the vessel (segment) as represented in the first diagnostic image and the same vessel segment as represented in the second diagnostic image may only be established with low accuracy.
  • This issue becomes even more severe in cases where the diagnostic images are acquired using different imaging modalities.
  • the co-registration of a CT angiogram with invasive angiography data shall be mentioned. Such registration of the CT angiogram to the angiography data may be very challenging since cardiac motion and/or unknown relative geometry may cause ambiguities.
  • Document US2011060755A1 may be considered to disclose a method and device that uses flow fraction in a correlation of vessel segments with vascular territories, and a visualises a vessel including a selected point of interest together with the corresponding tissue region within a correlated territory fed by the respective vessel segment.
  • a method for analyzing diagnostic image data which comprises the steps of obtaining a first diagnostic image and a second diagnostic image of a vessel of interest in a patient's vasculature, defining at least one determination position for the vessel of interest in the first diagnostic image and at least one corresponding determination position for the vessel of interest in the second diagnostic image, determining a first value for at least one functional parameter at the least one determination position for the first diagnostic image and a second value for the same at least one functional parameter at the corresponding determination position for the second diagnostic image, correlating one or more vessel positions along the vessel of interest as represented in the first diagnostic image with one or more vessel positions along the vessel of interest as represented in the second diagnostic image based on a comparing of the first value of the at least one functional parameter and the second value of the at least one functional parameter.
  • two diagnostic images are co-registered to one another on the basis of a functional parameter that has been determined for at least one particular determination position in both diagnostic images.
  • the term diagnostic image may particularly refer to an image representing the patient's vasculature.
  • vasculature may refer to a vessel tree or a single vessel.
  • vasculature may particularly refer to a vessel segment of the vessel of interest.
  • the diagnostic image may represent a vasculature including one or more vessels of interest of the coronary vasculature.
  • the first diagnostic image and the second diagnostic image may particularly be obtained by a diagnostic imaging modality.
  • the diagnostic imaging modality may particularly be gated.
  • the gated diagnostic imaging modalities may typically employ a gated reconstruction, in which the acquisition of the diagnostic images is performed in parallel with acquisition of data providing information over the cardiac cycle, such as electrocardiogram (ECG) or photoplethysmographic (PPG) data. This data may hereby be used to gate the image acquisition and the reconstruction by means of respectively selected phase points of the cardiac cycle.
  • ECG electrocardiogram
  • PPG photoplethysmographic
  • determination position may particularly refer to a particular position along the vessel of interest as represented in the first diagnostic image and in the second diagnostic image at which a value for a functional parameter may be determined, e.g. by an actual invasive measurement, such as an intravascular pullback measurement and/or a non-invasive measurement, such as a Doppler flow measurement, and/or by simulating the fluid dynamics through the vessel of interest using a respective fluid dynamics model.
  • a plurality of determination positions may be used, at each of which a corresponding value for one or more functional parameters may be determined.
  • the term functional parameter may particularly refer to parameters that are indicative of the dynamic behavior of the vessel of interest, in particular of the fluid dynamics through the vessel of interest. That is, functional parameters may refer to parameters such as pressure, flow, vascular resistance or the like which vary alongside a vessel of interest.
  • the term vessel position may particularly refer to a position along the vessel of interest.
  • a plurality of vessel positions may be determined along a length of the vessel of interest.
  • the vessel positions in the first diagnostic image and the second diagnostic image are correlated to one another by comparing the first and the second value of the at least one functional parameter obtained for the determination position in the first diagnostic image and the determination position in the second diagnostic image.
  • first values if a plurality of first values is obtained for a particular functional parameter in the first diagnostic image and a plurality of second values is obtained for the same functional parameter in the second diagnostic image, these values may be compared to one another.
  • the determination positions for which the values correspond to one another are then correlated to one another, i.e. are assumed to correspond to the same vessel position as represented in the two images.
  • At least one determination position is determined in both diagnostic images. Subsequently, a value of a functional parameter is determined for the at least one determination position.
  • the thus determined values, determined for the first diagnostic image and the second diagnostic image, respectively, are then compared to one another in order to establish a correlation.
  • these determinations positions are assumed to correspond to the same vessel position inside the vessel of interest due to exhibiting the same value for a particular functional parameter. This allows to perform correspondence detection between the first diagnostic image and the second diagnostic image, even in cases where the diagnostic images have been acquired using different acquisition settings and/or different imaging modalities.
  • the obtaining of the first diagnostic image and the second diagnostic image comprises acquiring the first diagnostic image by a first diagnostic imaging modality using a first acquisition setting, and acquiring the second diagnostic image by the first diagnostic imaging modality using a second acquisition setting, different from the first acquisition setting.
  • the first diagnostic image and the second diagnostic images may have been acquired using one particular diagnostic - or medical - imaging modality such as CT angiography, invasive angiography, IVUS imaging, MR imaging, ICE, TEE or the like with differing acquisition settings.
  • the first diagnostic image and the second diagnostic image may be acquired using two-dimensional X-ray angiography with two different acquisition settings, respectively.
  • acquisition settings may particularly refer to the setting of acquisition parameters, such as radiation time, projection direction, acquisition timing relative to the cardiac cycle or the like, that may be adjusted from patient to patient, or even from image to image.
  • acquisition parameters such as radiation time, projection direction, acquisition timing relative to the cardiac cycle or the like
  • a change in acquisition setting thus corresponds to the change of one or more acquisition parameters for performing the respective acquisition.
  • Such a change typically results in a change of the representation of the vessel of interest in the diagnostic image.
  • the obtaining of the first diagnostic image and the second diagnostic image comprises acquiring the first diagnostic image by a first diagnostic imaging modality, and acquiring the second diagnostic image by a second diagnostic imaging modality, different from the first diagnostic imaging modality.
  • the first diagnostic imaging modality corresponds to a non-invasive diagnostic imaging modality and the second diagnostic imaging modality corresponds to an invasive diagnostic imaging modality.
  • the first and second diagnostic image may also be acquired using different imaging modalities.
  • the first diagnostic image may have been acquired using a non-invasive imaging modality, such as CT angiography, X-ray angiography, MR imaging, US imaging or the like
  • the second diagnostic image may have been acquired using an invasive imaging modality, such as invasive angiography, IVUS imaging, ICE or TEE imaging or the like.
  • both, the first and the second diagnostic image may be acquired using an invasive imaging modality or both, the first and the second diagnostic image may be acquired using a non-invasive imaging modality. It shall further be understood that the respective acquisition settings may particularly depend on the individual imaging modalities used.
  • each imaging modality allows to visualize different aspects of the vessel of interest
  • the use of different imaging modalities allows to gather more information than would be available from the use of a single imaging modality.
  • the functional parameter values for correlating between the first diagnostic image and the second diagnostic image correspondence detection of the vessel of interest in the first diagnostic image and the second diagnostic image, respectively, is still possible irrespective of the different imaging method used for acquiring them.
  • the functional parameters are related to the dynamics of the vessel of interest and not (primarily) to the geometric properties - which may be represented differently when using different imaging modalities.
  • the combination of non-invasive and invasive techniques allows to acquire a wide variety of information about the vessel of interest. This improves the accuracy of the vessel assessment and, hence, the diagnosis of any possible ailments.
  • the determining of the first value and/or the second value of the at least one functional parameter comprises acquiring intravascular measurement data for the vessel of interest, and deriving, based on the intravascular measurement data, the first and second value of the at least one functional parameter at the at least one determination position. In some embodiments, the determining of the first value and/or the second value of the at least one functional parameter comprises generating a fluid dynamics model for the vessel of interest, and deriving, based on the fluid dynamics model, the first and second value of the at least one functional parameter at the at least one determination position.
  • the functional parameter values may particularly be derived from an invasive measurement of said functional parameter.
  • a catheter or the like having a respective measurement device attached thereto may be introduced into the patient's vasculature and, in particular, into the vessel of interest.
  • the measurement device may be used to acquire intravascular measurement data, such as values for one or more of a pressure, a flow, a vascular resistance or the like at dedicated positions along the length of the vessel of interest.
  • the first value of the at least one functional parameter may have been determined using first intravascular measurement data having been acquired by a first measurement modality and the second value of the at least one functional parameter may have been determined using second intravascular measurement data having been acquired by a second measurement modality.
  • the measurement data collected for the vessel of interest in the first diagnostic image and for the vessel of interest in the second diagnostic image may correspond to pullback data, such as pressure pullback data.
  • the pullback data may then comprise a plurality of first functional parameter values, one for each measurement position, i.e. each position at which a pullback measurement was performed, in the vessel of interest as shown in the first diagnostic image.
  • the pullback data may further comprise a plurality of second functional parameter values, one for each measurement position in the vessel of interest as shown in the second diagnostic image.
  • the functional parameter values may be derived from respective fluid flow simulations using a fluid dynamics model representing the blood flow through the vessel of interest and/or a blood flow through multiple vessels in the vasculature.
  • the term fluid dynamics model may hereby particularly refer to a model of the blood flow through the vessel of interest.
  • This fluid dynamics model is generated by simulating the interaction of the blood with the vessel wall. Since the blood is a fluid and the vessel walls may be considered respective surfaces with which the fluid interacts, the interaction of the blood with the vessel walls may most accurately be defined by respective boundary conditions that take account of the properties of the vessel wall and the blood interacting with it. These properties may include vessel wall composition, vessel wall elasticity and vessel impedance, bifurcations in the vessel, outflow through these bifurcations, blood viscosity, the vessel outlet resistance at certain positions along the length of the vessel and the like.
  • the fluid dynamics model may be integrated with a two- or three-dimensional geometric model and hereby represents the fluid dynamics of the blood at each position in the vessel or vessels of interest shown in the geometric model.
  • one - for example the first - functional parameter value may correspond to a measured value whereas the other - for example the second - functional parameter value may correspond to a simulated value, having been simulated by means of the fluid dynamics model.
  • the first functional parameter value may be obtained using a pullback measurement, such as a pressure, in particular FFR or iFR, pullback measurement, an ultrasonic flow measurement, such as a Doppler flow measurement, or the like and the second functional parameter may be obtained by means of simulating the corresponding function parameter using a fluid dynamics model.
  • the first diagnostic image may correspond to a CT angiography image and the second diagnostic image may correspond to an invasive angiography image, whereby the first functional parameter values for the first diagnostic CT angiography image correspond to simulated iFR values derived from a fluid dynamics model and the second functional parameter values for the second diagnostic invasive angiography image correspond to measured FFR or iFR pullback values.
  • the first diagnostic image may correspond to an IVUS image and the second diagnostic image may correspond to a CT or invasive angiography image and the correspondence detection is performed based on first and second functional parameter values, such as pressure or flow distributions, that have been simulated by means of a fluid dynamics model for both, the first and the second diagnostic image.
  • first and second functional parameter values such as pressure or flow distributions
  • two CT or invasive angiography images may be co-registered - thereby performing correspondence detection -based on simulated functional parameter values.
  • the first diagnostic image may also correspond to a neuro MR image and the second diagnostic image may correspond to an ultrasound (US) image, whereby the first functional parameter values for the first diagnostic image may have been obtained using MR based flow measurements and the second functional parameter values for the second diagnostic image may have been obtained using Doppler flow measurements.
  • US ultrasound
  • the first diagnostic image may correspond to a CT image which is provided along with a simulated flow distribution as the first functional parameter values and registered to an intravascular US image provided along with Doppler flow measurement values as the second functional parameter values.
  • the first diagnostic image may correspond to a CT image and the second diagnostic image may be an ICE image or TEE image and the correspondence detection may be performed by matching the first functional parameter values from Doppler flow measurements to the second functional parameter values derived from simulated flow distributions.
  • the correspondence detection may be performed by matching the first functional parameter values from Doppler flow measurements to the second functional parameter values derived from simulated flow distributions.
  • Other combinations are likewise possible.
  • the method further comprises obtaining one or more acquisition parameters used to acquire the first diagnostic image and/or the second diagnostic image, respectively, and correlating the one or more vessel positions along the vessel of interest as represented in the first and second diagnostic images, respectively, based on the one or more acquisition parameters.
  • the acquisition parameters used to acquire the first diagnostic image and the second diagnostic image may be used as further information for performing the correspondence detection.
  • Acquisition parameters that may be used as such further information may particularly relate to the projection geometry, the heart phase and certain image features of the first and second diagnostic images, respectively.
  • One or more of these acquisition parameters may hereby be combined in order to remove ambiguities and/or inaccuracies that may result from uncertainties that may be present when performing correspondence detection.
  • the orientation of the vessel of interest in the diagnostic image may be determined.
  • the inherent error of misidentifying a vessel of interest in the first diagnostic image and/or the second diagnostic image when performing correspondence detection between these two can be reduced, as the projection geometry is known. It is thus possible to indicate how the vessel of interest should be represented in a diagnostic image for a particular projection geometry (or other factors exhibiting an influence on the vessel of interest and its representation in a diagnostic image in a similar manner), thereby allowing to accurately perform correspondence detection.
  • the acquisition parameters may be used to remove an uncertainty about the vessel identification.
  • an FFR or iFR pullback measurement may have resulted in the acquisition of a plurality of pressure values that could be matched to either the pressure values that have been simulated for the left anterior descending (LAD) or the pressure values that have been simulated for the left circumflex artery (LCx).
  • Knowledge of the projection geometry, in particular the projection angles of one or more invasive angiography images recorded along with the FFR or iFR pullback data may resolve whether the data is to be matched to the LAD or the LCx.
  • the acquisition parameters may be used as further information to provide an initial starting point for the correspondence detection.
  • knowledge about the projection geometry of one or more invasive angiography images and about the reconstruction geometry of one or more computed tomography (CT) angiography images may assist in performing initial co-registration of the image data from invasive angiography and CT angiography, respectively.
  • This initial co-registration may then be used as the starting point for further correspondence detection, which then takes account of the (coronary) motion and potential miss-calibrations by matching e.g. pressure values from an FFR or iFR pullback measurement to respective simulated pressure values.
  • further additional information e.g. geometric information about the vessel of interest itself may also assist in providing a more accurate correspondence detection.
  • further geometric information may allow to uniquely identify the vessel position in case multiple vessel positions may be matched to one particular functional parameter value.
  • a pressure value obtained by an invasive measurement for one particular vessel position as visible in e.g. an invasive angiography image might be matched, as a first value, to two or more simulated pressure values at two or more vessel positions in a respective CT angiography image, the second values. That is, the vessel position in the CT angiography image that corresponds to the vessel position in the invasive angiography image is ambiguous.
  • the invasive and the CT angiography image at the particular vessel positions allows to determine at which vessel position the vessel size as seen in the invasive angiography image matches the vessel size in the CT angiography image the best. This best match then allows to uniquely identify the particular vessel positions in the CT angiography image that is to be matched to the one vessel position in the invasive angiography image.
  • the correlating the one or more vessel positions along the vessel of interest as represented in the first diagnostic image with the one or more vessel positions along the vessel of interest as represented in the second diagnostic image comprises determining a point to point correspondence for the one or more vessel positions along the vessel of interest as represented in the first and second diagnostic image, respectively.
  • correspondence detection is performed by creating a point to point correspondence between the vasculature as shown in the first and the second diagnostic image by matching the first and second values of the corresponding functional information to one another.
  • the point to point correspondence may then be used for multi-modality vessel modeling or multi-modality image visualization.
  • the point to point correspondence may particularly be achieved by determining the outflow, in particular the virtual outflow, and consecutively matching peaks of said (virtual) outflow as derived for the first diagnostic image and the second diagnostic image, respectively, to one another.
  • the point to point correspondence determination is further performed on the basis of additional information about the acquisition parameters, such as projection geometry or the like, as indicated herein above.
  • the first diagnostic image and/or the second diagnostic image may have been acquired using one or more of computed tomography (CT) angiography and/or invasive angiography and/or intravascular ultrasound (IVUS) imaging and/or magnetic resonance (MR) imaging and/or intracardiac echocardiography (ICE) and/or transesophageal echocardiography (TEE).
  • CT computed tomography
  • IVUS invasive angiography and/or intravascular ultrasound
  • MR magnetic resonance
  • ICE intracardiac echocardiography
  • TEE transesophageal echocardiography
  • a variety of different (medical) imaging modalities can be envisioned for the purpose of the development. Further, a variety of functional parameter measurements may be acquired, such as by IVUS, TEE, ICE or the like.
  • the method further comprises training a classifying device with a training dataset indicative of a correlation between a vessel of interest in the first diagnostic image and the second diagnostic image to obtain a classification result, and comparing the first value of the at least one functional parameter and the second value of the at least one functional parameter based on the classification result.
  • the matching of the functional parameter values as derived for the first diagnostic image and the second diagnostic image, respectively may also be performed by means of a machine learning algorithm, which may particularly be implemented as a trained classifier or in terms of a neural network.
  • the machine learning algorithm, and in particular the classifier may particularly be trained with a training dataset that is indicative of correlation of vessel of interest and functional parameter values.
  • the classifier uses the training result to perform the matching of the functional parameter values between the first and second diagnostic images, respectively, thereby generating the point to point correspondence.
  • the method further comprises segmenting the vessel of interest as represented in the first diagnostic image and the second diagnostic image, respectively, and based on said segmenting, generating a physiological model of the vessel of interest.
  • the first and second diagnostic image may be used for generating a physiological model of the vessel of interest. That is, upon correspondence detection having been performed, the information gathered by using different acquisition settings and/or different imaging modalities may be used to generate a more thorough physiological model of the vessel of interest.
  • the vessel of interest as represented in the first and second diagnostic image may be segmented into a plurality of segments.
  • the physiological model of the vessel of interest may be generated, which comprises a geometric model of the vessel of interest, i.e. a geometric representation of the vessel of interest and/or the entire vasculature.
  • This geometric model may typically be a two- or three-dimensional model, depending on the information that may be derived from the first and second diagnostic image.
  • the geometric model may be a three-dimensional model and if the first and/or second diagnostic image allow to derive information in two dimensions, the geometric model may be two-dimensional model. In other embodiments, where only two-dimensional information is available, the geometric model may also be a quasi three-dimensional model with the third dimension interpolated from the other two dimensions,
  • an apparatus for analyzing diagnostic image data comprising an input unit configured to obtain a first diagnostic image and a second diagnostic image of a vessel of interest in a patient's vasculature, a defining unit configured to define at least one determination position for the vessel of interest in the first diagnostic image and at least one corresponding determination position for the vessel of interest in the second diagnostic image, a determination unit configured to determine a first value for at least one functional parameter at the least one determination position for the first diagnostic image and a second value for the same at least one functional parameter at the corresponding determination position for the second diagnostic image and a correlation unit configured to correlate one or more vessel positions along the vessel of interest as represented in the first diagnostic image with one or more vessel positions along the vessel of interest as represented in the second diagnostic image based on a comparing of the first value of the at least one functional parameter and the second value of the at least one functional parameter.
  • the apparatus further comprises a modelling unit configured to generate a physiological model of the vessel of interest based on the first diagnostic
  • a computer program for controlling an apparatus according to the invention is provided, which, when executed by a processing unit, is adapted to perform the method steps according to the invention.
  • a computer-readable medium is provided having stored thereon the above-cited computer program.
  • Fig. 1 represents schematically an exemplary embodiment of an apparatus 1 for analyzing diagnostic image data.
  • the apparatus 1 comprises an input unit 100, a defining unit 200, a determination unit 300, a correlation unit 400, a modelling unit 500 and a display unit 600.
  • Input unit 100 is configured to receive a first diagnostic image 10 and a second diagnostic image 20.
  • the first diagnostic image 10 and the second diagnostic image 20 correspond to two-dimensional images which have been acquired using the same imaging modality, namely X-ray angiography, using different acquisition settings.
  • the first diagnostic image 10 has been acquired with a different projection direction than the second diagnostic image 20.
  • apparatus 1 is configured to receive two diagnostic images acquired by the same imaging modality, apparatus 1 is also configured to process a first diagnostic image 10 acquired using a first imaging modality and a second diagnostic image 20 acquired using a second imaging modality.
  • input unit 100 is further configured to receive data 30 indicating the respective acquisition settings used to acquire the first diagnostic image 10 and the second diagnostic image 20. In the exemplary embodiment according to Fig. 1 , it is the input unit 100 that is further configured to obtain, from data 30, the acquisition parameters. In other embodiments, defining unit 200, determination unit 300 and/or correlation unit 400 may, alternatively or additionally, be configured to retrieve said acquisition parameters.
  • Input unit 100 is further configured to provide the first diagnostic image 10, the second diagnostic image 20 and the derived acquisition parameters to defining unit 200.
  • Defining unit 200 is configured to receive the first diagnostic image 10 and the second diagnostic image 20 and to define at least one determination position for a respective vessel of interest as shown in the first diagnostic image 10 and the second diagnostic image 20.
  • defining unit 200 defines three determination positions along a longitudinal axis of the vessel of interest in the first diagnostic image 10 and three corresponding determination positions along a longitudinal axis of the vessel of interest in the second diagnostic image 20. It shall be understood that, in other embodiments, defining unit 200 may define more or less determination positions for the vessel of interest.
  • defining unit 200 provides data indicating the defined determination positions along with the first diagnostic image 10 and the second diagnostic image 20 to determination unit 300.
  • Determination unit 300 is configured to receive, from defining unit 200, the first diagnostic image 10 and the second diagnostic image 20 as well as the data indicating the defined determination positions. Further, determination unit 300 is configured to receive intravascular measurement data 40 which, in the specific embodiment according to Fig. 1 , corresponds to pressure pullback data that has been acquired by slowly pulling back a pressure wire through the vessel of interest.
  • Determination unit 300 is further configured to determine, based on the intravascular measurement data 40, respective values for at least one functional parameter at the respective determination positions.
  • determination unit 300 is configured to obtain a first pressure value for the first determination position, a first pressure value for the second determination position and a first pressure value for the third determination position from the first diagnostic image 10.
  • Further determination unit 300 is configured to obtain a second pressure value for the first corresponding determination position, a second pressure value for the second corresponding determination position and a second pressure value for the third determination position from the second diagnostic image 20.
  • Determination unit 300 then provides data indicating the first and second pressure values obtained from the first diagnostic image 10 and the second diagnostic image 20 at the three respective determination positions, respectively, to correlation unit 400, along with the first diagnostic image 10, the second diagnostic image 20 and, optionally, the acquisition parameters.
  • Correlation unit 400 is configured to receive the data indicating the first and second pressure values, the first diagnostic image 10 and the second diagnostic image 20 and, optionally, the acquisition parameters. Correlation unit 400 then compares the first and second pressure values with one another in order to determine a correlation between a first plurality of vessel positions along a longitudinal axis of a vessel of interest as represented in the first diagnostic image 10 and a second plurality of vessel positions along a longitudinal axis of the same vessel of interest as represented in the second diagnostic image 20. In the specific embodiment according to Fig. 1 , the correlation unit 400 particularly regards a pressure distribution as derived from the first and second pressure values and matches the pressure distribution as determined for the first pressure values to the pressure distribution as determined for the second pressure values.
  • correlation unit 400 may establish a point to point correspondence between the vessel of interest as shown in the first diagnostic image 10 and the vessel of interest as shown in the second diagnostic image 20. That is, it is determined for each vessel position of the vessel of interest in the first diagnostic image 10 the corresponding vessel position of the vessel of interest in the second diagnostic image 20.
  • the deriving of the point to point correspondence is further supported by the information about the acquisition parameters.
  • modelling unit 500 Upon registration of the vessel of interest in the first diagnostic image 10 to the vessel of interest in the second diagnostic image 20, the registered plurality of images is provided to modelling unit 500. Modelling unit 500 segments the vessel of interest in the first diagnostic image 10 and the second diagnostic image 20 and generates a physiological model of the vessel of interest.
  • the physiological model in particular comprises a geometric model allowing to derive the geometry of the vessel of interest.
  • the physiological model may also comprise a fluid dynamics model.
  • Modelling unit 500 is further configured to provide, upon generating the model, the generated model, optionally along with the first diagnostic image 10 and the second diagnostic image 20, to display unit 600 comprising a screen 601 and a user interface 602.
  • Display unit 600 is configured to generate a graphical representation of the physiological model and to present this graphical representation, optionally along with one or both of the first diagnostic image 10 and the second diagnostic image 20, to a user.
  • the user may interact with the model via user interface 602.
  • Fig. 2 represents an approach for correlating a vessel of interest as represented in the first diagnostic image 10 and the second diagnostic image 20.
  • the first diagnostic image 10 and the second diagnostic image 20 correspond to coronary angiograms which have been acquired using different projection directions.
  • a fluid dynamics model is generated from the first diagnostic image 10 and the second diagnostic image 20.
  • the fluid dynamics model is then used to simulate the functional parameters for at least the determination positions 11, 12, 13, 21, 22 and 23 along the vessel of interest.
  • the fluid dynamics model is used to derive the virtual outflow through the vessel of interest at determination positions 11, 12 and 13 for diagnostic image 10 and at determination positions 21, 22 and 23 for diagnostic image 20.
  • correlation unit 400 performs a matching of the peaks of virtual outflow through the vessel of interest, thereby providing a point to point reference between the at least two images.
  • FIG. 3 schematically shows apparatus 1' which is a modification of the apparatus 1 according to Fig. 1 .
  • apparatus 1' also comprises an input unit 100, a defining unit 200, a determination unit 300, a modelling unit 500 and a display unit 600.
  • Apparatus 1' further comprises a correlation unit 400' comprising a classifying device 401.
  • input unit 100 receives a first diagnostic image 10' that has been acquired by a first imaging modality, which, in the specific case of Fig. 2 , corresponds to X-ray angiography. Further, input unit 100 receives a second diagnostic image 20' that has been acquired using a second imaging modality, which, in this specific case, corresponds to magnetic resonance imaging. It shall be understood that, although the apparatus 1' is configured to receive (and process) a first diagnostic image 10' and a second diagnostic image 20' acquired with two different imaging modalities, apparatus 1' could likewise receive and process a first diagnostic image 10 and a second diagnostic image 20 as acquired with one particular imaging modality.
  • correlation unit 400' comprises a classifying device 401.
  • Classifying device 401 has been trained by training dataset 50, which is typically provided to classifying device 401 prior to correlation, with a correspondence between at least one functional parameter along a vessel of interest as represented in a first diagnostic image 10 and a second diagnostic image 20.
  • the classifying device receives the first diagnostic image 10 and the second diagnostic image 20 and classifies the two diagnostic images in order to establish the point to point correspondence.
  • the registered diagnostic images are provided to modelling unit 500 which then proceeds as described in relation to Fig. 1 .
  • Fig. 4 schematically represents a method 1000 for analyzing diagnostic image data as executed by apparatus 1.
  • input unit 100 receives the first diagnostic image 10 and the second diagnostic image 20.
  • input unit 100 further receives data 30 indicative of the acquisition settings used for acquiring the first diagnostic image 10 and the second diagnostic image 20.
  • the input unit 100 derives the relevant acquisition parameters from data 30 and provides the first diagnostic image 10 and the second diagnostic image 20 along with the acquisition parameters derived from data 30 to defining unit 200.
  • step S201 defining unit 200 receives the first diagnostic image 10 and the second diagnostic image 20 along with the acquisition parameters.
  • step S202 defining unit 200 defines at least one determination position for a respective vessel of interest as shown in the first diagnostic image 10 and the second diagnostic image 20.
  • defining unit 200 again defines three determination positions along the vessel of interest in the first diagnostic image 10 and three corresponding determination positions along the vessel of interest in the second diagnostic image 20.
  • Defining unit 200 then provides the first diagnostic image 10 and the second diagnostic image 20 and the data indicating the defined determination positions to determination unit 300.
  • determination unit 300 receives the first diagnostic image 10, the second diagnostic image 20 and the data indicating the determination positions from determination unit 300 and further receives intravascular measurement data 40 indicative of at least one functional parameter.
  • determination unit 300 derives, based on the intravascular measurement data 40, respective values for the at least one functional parameter at the respective determination positions.
  • determination unit 300 particularly derives a first pressure value for the first determination position, a first pressure value for the second determination position and a first pressure value for the third determination position from the first diagnostic image 10 and derives a second pressure value for the first corresponding determination position, a second pressure value for the second corresponding determination position and a second pressure value for the third corresponding determination position from the second diagnostic image 20.
  • step S303 determination unit 300 provides the first diagnostic image 10, the second diagnostic image 20 and, optionally, the acquisition parameter as indicated by data 30 along with data indicating the first and second pressure values obtained from the first diagnostic image 10 and the second diagnostic image 20 at the three corresponding determination positions to correlation unit 400.
  • step S401 correlation unit 400 receives the first diagnostic image 10 and the second diagnostic image 20 along with the data indicating the first and second pressure values, and, optionally, the acquisition parameters.
  • step S402 correlation unit 400 compares the first and second pressure values with one another and, in step S403, determines a correlation between a first plurality of vessel positions along the vessel of interest as represented in the first diagnostic image 10 and a second plurality of vessel positions the same vessel of interest as represented in the second diagnostic image 20 and thus performs a vessel registration for the vessel of interest. Subsequently, correlation unit 400 provides the registered plurality of images to modelling unit 500.
  • modelling unit 500 receives the registered plurality of images and segments, in step S502, the vessel of interest in the first diagnostic image 10 and the second diagnostic image 20.
  • modelling unit 500 generates a physiological model of the vessel of interest and provides the generated model, optionally along with the first diagnostic image 10 and the second diagnostic image 20, to display unit 600.
  • step S601 display unit 600 then generates a graphical representation of the physiological model, optionally including the first diagnostic image 10 and/or second diagnostic image 20.
  • step S602 display unit 600 then displays the graphical representation to a user, upon which display a user may interact with the displayed information.
  • the first diagnostic image and the second diagnostic image have been acquired using X-ray angiography with different acquisition settings, it shall be understood that the first diagnostic image and the second diagnostic image may also be acquired using a different imaging modality, such as invasive angiography, neuro MR imaging, US imaging, CT imaging, ICE imaging, TEE imaging or the like.
  • a different imaging modality such as invasive angiography, neuro MR imaging, US imaging, CT imaging, ICE imaging, TEE imaging or the like.
  • the functional parameter values correspond to pressure values
  • further functional (dynamic) parameter values may be used such as flow, vascular resistance or the like.
  • a single unit or device may fulfill the functions of several items recited in the claims.
  • the mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage.
  • Procedures like the defining of the at least one determination position, the determining of the first and second value of the at least one functional parameter, the correlation the one or more vessel positions, the generating of a fluid dynamics model and the deriving, based on the fluid dynamics model, the first and second value of the at least one functional parameter, the generating of the physiological model, et cetera, performed by one or several units or devices can be performed by any other number of units or devices.
  • These procedures particularly the control of the apparatus for analyzing the diagnostic image data in accordance with the control method carried out by ta respective apparatus controller, can be implemented as program code means of a computer program and/or as dedicated hardware.
  • a computer program may be stored/distributed on a suitable medium, such as an optical storage medium or a solid-state medium, supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems.
  • a suitable medium such as an optical storage medium or a solid-state medium, supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems.
  • the disclosure relates to a method for analyzing diagnostic image data comprising: obtaining a first diagnostic image and a second diagnostic image of a vessel of interest in a patient's vasculature, defining at least one determination position for the vessel of interest in the first diagnostic image and at least one corresponding determination position for the vessel of interest in the second diagnostic image, determining a first value for at least one functional parameter at the least one determination position for the first diagnostic image and a second value for the same at least one functional parameter at the corresponding determination position for the second diagnostic image, correlating one or more vessel positions along the vessel of interest as represented in the first diagnostic image with one or more vessel positions along the vessel of interest as represented in the second diagnostic image based on a comparing of the first value of the at least one functional parameter and the second value of the at least one functional parameter.

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Claims (15)

  1. Une méthode pour analyser des données d'images diagnostic, comprenant l'exécution des étapes suivantes avec, ou sur, ou en utilisant, ou par des moyens d'un appareil comprenant une unité d'entrée (100) :
    une unité d'entrée obtenant une première image de diagnostic (10) et une deuxième image de diagnostic (20) d'un vaisseau sanguin d'intérêt dans le système vasculaire du patient, définissant au moins une position de détermination pour le vaisseau sanguin d'intérêt dans la première image de diagnostic et au moins une position de détermination correspondante pour le vaisseau sanguin d'intérêt dans l'image du second diagnostic, déterminer une première valeur pour au moins un paramètre fonctionnel d'au moins une position de détermination pour la première image de diagnostic et une seconde valeur pour le même paramètre fonctionnel d'au moins une position de détermination correspondante pour la seconde image de diagnostic, corrélant une ou plusieurs positions des vaisseaux sanguins le long du vaisseau d'intérêt comme représenté dans la première image de diagnostic avec une ou plusieurs positions de vaisseau sanguin d'intérêt comme représenté dans la seconde image de diagnostic fondée sur la comparaison de la première valeur d'au moins un paramètre fonctionnel et la seconde valeur d'au moins un paramètre fonctionnel, enregistrant les premières et secondes images de diagnostic.
  2. La méthode selon la revendication 1, où l'obtention de la première image diagnostic et la seconde image diagnostic comprend:
    la réception d'une première image diagnostic par une première modalité d'imagerie diagnostique utilisant un premier paramètre d'acquisition, et la réception de la seconde image diagnostic par la première modalité d'imagerie diagnostique utilisant un second paramètre d'acquisition, différent du premier paramètre d'acquisition.
  3. La méthode selon la revendication 1, où l'obtention de la première image diagnostic et la seconde image diagnostic comprend:
    la réception d'une première image diagnostic par une première modalité d'imagerie diagnostic et la réception d'une seconde image diagnostic par une seconde modalité d'imagerie diagnostique différente de la première modalité d'imagerie diagnostique.
  4. La méthode selon la revendication 3, où la modalité d'imagerie diagnostique correspond à une modalité d'imagerie diagnostique non invasive et la seconde modalité d'imagerie diagnostique correspond à une modalité d'imagerie diagnostique invasive.
  5. La méthode selon la revendication 1, où la détermination de la première valeur et/ou la seconde vanne d'au moins un paramètre fonctionnel comprennent:
    la réception de données de mesure intravasculaire pour le vaisseau d'intérêt, et la dérivation, fondée sur les données de mesure intravasculaire, les premières et secondes valeurs d'au moins un paramètre fonctionnel d'au moins une position de détermination.
  6. La méthode selon la revendication 1, où la détermination de la première valeur et/ou la seconde vanne d'au moins un paramètre fonctionnel comprend: la production d'un modèle de dynamique des fluides pour le vaisseau d'intérêt, et dériver, fondé sur le modèle de dynamique des fluides, la première et seconde valeur d'au moins un paramètre fonctionnel d'au moins une position de détermination.
  7. La méthode selon la revendication 1 comprend également:
    l'obtention d'un ou plusieurs paramètres d'acquisition utilisée pour obtenir la première image diagnostic et/ou la seconde image diagnostic, respectivement, et corrélant une ou plusieurs positions de vaisseaux sanguins le long du vaisseau sanguin d'intérêt comme représenté dans les premières et secondes images diagnostic, respectivement, fondé sur un ou plusieurs paramètres d'acquisition.
  8. La méthode selon la revendication 1, où la corrélation d'une ou plusieurs positions de vaisseaux sanguins le long d'un vaisseau sanguin d'intérêt comme représenté dans la première image diagnostic avec une ou plusieurs positions de vaisseau sanguin le long du vaisseau d'intérêt comme représenté dans la seconde image diagnostic comprend la détermination d'une correspondance point à point pour une ou plusieurs positions de vaisseau sanguin le long du vaisseau d'intérêt comme représenté dans la première et seconde image diagnostic, respectivement.
  9. La méthode selon la revendication 1, où la première image diagnostic et/ou la seconde image diagnostic sont acquises utilisant une ou plusieurs:
    angiographie par tomodensitométrie et/ou angiographie et/ou une imagerie d'échographie intravasculaire et/ou une résonance d'imagerie magnétique et/ou une échocardiographie intracardiaque et une échocardiographie transœsophagienne.
  10. La méthode selon la revendication 1, comprend également:
    l'entraînement d'un dispositif de classification avec un ensemble de données de formation indicatives d'une corrélation entre un vaisseau sanguin d'intérêt dans la première image diagnostic et la seconde image diagnostic pour obtenir un résultat de classification, et comparer la première valeur d'au moins un paramètre fonctionnel et la seconde valeur d'au moins un paramètre fonctionnel fondé sur le résultat de classification.
  11. La méthode selon la revendication 1, comprend également:
    la segmentation du vaisseau sanguin d'intérêt comme représenté dans la première image diagnostic et la seconde image diagnostic, respectivement, et fondé sur ladite segmentation, la production d'un modèle physiologique du vaisseau sanguin d'intérêt.
  12. Un appareil pour analyser des données d'image diagnostic comprend: une unité d'entrée (100) configurée pour obtenir une première image de diagnostic et une seconde image de diagnostic d'un vaisseau d'intérêt dans le système vasculaire du patient, une unité de définition (200) configurée pour définir au moins une position de détermination pour le vaisseau d'intérêt dans la première image diagnostic et au moins une position de détermination correspondante pour le vaisseau d'intérêt dans la seconde image diagnostic, une unité de détermination (300) configurée pour déterminer une première valeur pour au moins un paramètre fonctionnel au moins une position de détermination pour la première image diagnostic et une seconde valeur pour le même paramètre fonctionnel à la position de détermination correspondante pour la seconde image diagnostic, une unité de corrélation (400) configurée pour corréler une ou plusieurs positions de vaisseau le long du vaisseau d'intérêt comme représenté dans la première image diagnostic avec une ou plusieurs positions de vaisseaux le long du vaisseau d'intérêt comme représenté dans la seconde image diagnostic fondé sur une comparaison d'une première valeur d'au moins un paramètre fonctionnel et la seconde valeur d'au moins un paramètre fonctionnel.
  13. La méthode selon la revendication 12 comprend également: une unité de modélisation (500) configurée pour produire un modèle physiologique du vaisseau d'intérêt fondé sur une première image diagnostic et la seconde image diagnostic.
  14. Un programme informatique, lorsqu'exécuté par une unité de traitement, est adapté à exécuter la méthode selon l'une quelconque des revendications 1 à 11 pour contrôler un appareil selon l'une quelconque des revendications 12 ou 13.
  15. Un support lisible par ordinateur ayant stocké sur celui-ci un élément de programme informatique de la revendication 14.
EP20733452.5A 2019-06-28 2020-06-23 Registrement des vaisseaux sanguins à l'aide d'informations fonctionnelles Active EP3989832B1 (fr)

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EP19183270.8A EP3756549A1 (fr) 2019-06-28 2019-06-28 Registrement des vaisseaux sanguins à l'aide d'informations fonctionnelles
PCT/EP2020/067390 WO2020260219A1 (fr) 2019-06-28 2020-06-23 Enregistrement de vaisseau à l'aide d'informations fonctionnelles

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US11064964B2 (en) * 2007-03-08 2021-07-20 Sync-Rx, Ltd Determining a characteristic of a lumen by measuring velocity of a contrast agent
EP2036497A1 (fr) * 2007-09-17 2009-03-18 Amid s.r.l. Procédé pour la génération d'images quantitatives du potentiel de flux d'une région en cours d'investigation
US20110060755A1 (en) * 2008-03-06 2011-03-10 Koninklijke Philips Electronics N.V. Method of selectively and interactively processing data sets
JP6475134B2 (ja) * 2015-09-29 2019-02-27 富士フイルム株式会社 細胞評価装置および方法
EP3456248A1 (fr) * 2017-09-14 2019-03-20 Koninklijke Philips N.V. Paramètres hémodynamiques permettant le co-enregistrement
EP3476294B1 (fr) * 2017-10-27 2023-06-28 Siemens Healthcare GmbH Détermination d'une position de ponction d'un vaisseau
WO2019126372A1 (fr) * 2017-12-20 2019-06-27 Heartflow, Inc. Systèmes et procédés pour effectuer une évaluation de traitements simulée par ordinateur sur une population cible
JP7348916B2 (ja) * 2018-05-23 2023-09-21 アシスト・メディカル・システムズ，インコーポレイテッド 画像データを使用した流量測定
US20220015730A1 (en) * 2018-11-28 2022-01-20 Koninklijke Philips N.V. Most relevant x-ray image selection for hemodynamic simulation
JP2022519876A (ja) * 2019-02-06 2022-03-25 チューリッヒ大学 対象となる導管を通る流体の流れを決定するシステムおよび方法

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EP3989832A1 (fr) 2022-05-04
JP2022538999A (ja) 2022-09-07
CN114173649A (zh) 2022-03-11
WO2020260219A1 (fr) 2020-12-30
US20220262000A1 (en) 2022-08-18

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